Wealthier Ohio counties more likely to have higher COVID vaccine rates

On Apr 19, 2021

Associate Director of Pharmacy Ariane Schieber measures a dose of the COVID-19 vaccine as frontline workers received booster shots at Ohio State University East hospital.

Ohio’s wealthiest county is also its most vaccinated against COVID-19, a connection that doesn’t come as a surprise to most experts who see it as a result of long-term disparities in health care.

At $107,854, Delaware County has the highest median household income of any of the state’s 88 counties, U.S. Census data shows. As of Wednesday, Delaware County also has the highest COVID-19 vaccination rate at 46.8%, which was nearly 10 percentage points higher than the statewide rate of 36%, according to the Ohio Department of Health.

Education, access keys to higher COVID vaccination rates

“It’s an old story,” said Amy Fairchild, dean of Ohio State University’s College of Public Health. “There’s a long history of literature on how income affects education, which affects trust in the medical system and also reflects access to care…It’s showing up again.”

As the COVID-19 vaccine rollout began in December, leaders faced questions about how they would ensure the distribution of shots was equitable.

In Ohio, vaccines were distributed to each county mostly based on population and a few risk. But, the state didn’t require Ohioans to get their shots in their counties of residence, meaning people with the time and the means could travel to get vaccinated.

People with more flexibility in their jobs tend to make more money and have good access to transportation, said Amy Rohling McGee, president of the Columbus-based Health Policy Institute of Ohio. That translates to more access to COVID-19 shots and health care services as a whole, she said.

“It’s becoming easier to get appointments, although it still is somewhat challenging,” Rohling McGee said. “We’re going to need to make sure that extra efforts are made to reach those people who are working in those kinds of jobs that don’t have that flexibility.”

Biggest divide on Ohio COVID vaccine rates: Suburban vs. rural counties

There is a 27 percentage point difference in vaccination rates between Ohio’s wealthiest and poorest counties.

The fact that Delaware County’s vaccination rate is 46.8% and Adams — a county with a median household income of $39,079 and a rate of 19.7% — shows that health disparities may be to blame. It’s also a sign, she said, that it’s time to “recalibrate” vaccination efforts and look at what’s working in one county versus what hasn’t panned out in another.

The correlation between wealth and vaccination levels didn’t come as a shock to Bill LaFayette, owner of the locally-based economic consulting firm Regionomics.

LaFayette said he could probably guess a lot of the most vaccinated counties simply based on income.

He joked that Geauga County in northeast Ohio was likely high on the list. Geauga County has a median household income of $82,303 and has the sixth-highest vaccination rate at 39.9% after Delaware, Ottawa, Lake, Wood and Warren counties, a Dispatch analysis found.

“I only know that because I have inside information,” LaFayette joked. “It makes sense.”

There’s no one reason Delaware County has been so successful in its vaccination efforts relative to other counties, Traci Whittaker, Delaware County Health Department spokeswoman said via email.

The health department has “great working relationships” with community leaders who have helped to secure appointments for individuals with barriers there, including a lack of transportation and internet, Whittaker said. Until recently, Whittaker said the county was also running vaccination clinics six days a week, including some Sundays.

Whittaker acknowledged that some Ohioans outside of Delaware County may have less access to vaccinations and locations to get them at.

“A large part of the population has easy access to healthcare, whereas some of Ohio’s smaller, more rural counties may not have that same connection or opportunity,” Whittaker said.

Politics also a factor in who chooses to get vaccinated

While many of Ohio’s wealthiest counties are the most inoculated, that rule doesn’t hold true for every single one. One which breaks the correlation is Holmes County, which is the least vaccinated in the state.

Holmes County, with a median household income of $63,753, is Ohio’s 16th richest county. Just 12.3% of Homes County was immunized as of Wednesday, showing that while income is a good indicator of vaccination, it’s not the only factor, Fairchild said.

Politics, Fairchild said, have made the vaccine rollout more divisive and led to followers of one political party being less likely to take a jab than supporters of another. Misinformation has become rampant on social media, which has likely turned some off to the shots, she said.

Longstanding hesitancy and mistrust, such as in the Black community and among LGBTQ+ Americans may also be to blame, though it’s unclear yet just how much of an impact it will have.

Whatever the reason, it’s clear that it will take pinpointed efforts to reach Ohioans who may be skeptical of the vaccines or those who are less fortunate and therefore have less access to a shot provider, Fairchild said.

Wealthier Ohio counties more likely to have higher COVID vaccine rates

Education, access keys to higher COVID vaccination rates

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